WPF Resource Page: The National Health Information Network Page

About the NHIN, World Privacy Forum testimony and Comments, NHIN resources, NHIN Timeline

What is the NHIN?

The National Health Information Network (NHIN) is an ambitious modernization plan proposed by the U.S. government. The idea is to move as an entire nation from paper medical files to electronic medical files that are shared. Specifically, the government goal is to digitize patients’ health records and medical files and create a national network to place the information in. The network, called the NHIN, would be a sophisticated network that hospitals, insurers, doctors, and others could potentially access. Such a network brings patient privacy, security, and confidentiality issues into sharp relief.

As of spring 2009, the development of the network is well underway. The official beginnings of the NHIN trace back to April 2004 when President Bush signed an Executive Order mandating that most Americans should have electronic medical files, or electronic health records (EHRs) within ten years. This order created a new Office of the National Coordinator for Health Information Technology and also mandated the updating of the nation’s medical information systems, including networked systems. It is the mandate for networked systems in particular that underlies the creation of the NHIN. The Obama administration stimulus bill infused a great deal of money into healthcare IT, which includes a variety of NHIN projects. The bill also included language that made the National Coordinator position more of a permanent feature in the government.

It will be important for all individuals to pay attention to these plans as they develop and to give input into how the medical and patient “information modernization” should be accomplished. It is the World Privacy Forum’s goal to help ensure that Electronic Health Records, Personal Health Records, and the NHIN are built from the ground up with great attention to patient choice, privacy, security, and confidentiality. It is also the World Privacy Forum’s goal that risks resulting from medical identity theft, which are significant, be mitigated and planned for in any NHIN.

NHIN Timeline

It is useful to see how the NHIN is developing over time. The World Privacy Forum has created a timeline that traces the key developments in this nationwide project and helps give a quick visual mapping of events. In December of 2008, the NHIN became least a partial reality as the active NHIN trials gave their reports.

The Office of the National Coordinator for Health Information Technology NHIN page contains some foundational documents on the NHIN including the Request For Information (2004) and the summary of responses to the request. Over 500 organizations, including the World Privacy Forum, responded to the RFI with comments. http://www.os.dhhs.gov/healthit/nhin.html

The general landing page for the Office of Health Information Technology is a prime resource for general issues regarding EHRs and the NHIN.http://www.os.dhhs.gov/healthit/

May 2006, a series of contracts were approved laying the groundwork for the NHIN.

November 2005, a series of pilot projects for the NHIN were approved and set in motion.

In June 2005, an American Health Information Community was announced. The “community” is chartered with helping the transition from paper to electronic medical files.http://www.os.dhhs.gov/healthit/ahic.html.

This new WPF report finds that medical identity theft is still a crime that causes great harms to its victims, and that it is growing overall in the United States; however, there’s a catch. The national consumer complaint data suggests that the crime is growing at different rates in different states and regions of the US, creating medical identity theft “hotspots.” These hotspots are important for patients, policymakers, and healthcare stakeholders to know about so as to address potential risks.

WPF has conducted original research on India's Aadhaar, a national biometric ID system, including field research in India during 2010-2014. WPF has published the original research in a peer-reviewed journal, Nature-Springer, and in Harvard-based Journal of Technology Science. The research found that systemic challenges to data protection and privacy exist in the Aadhaar system, challenges which do have potential remedies. Key lessons can be learned for both the US and the EU as biometric systems grow in popularity.